Dr Rajinder Singh demonstrating the use of the Tele-stroke service.

A Tele-stroke service linking the National Neuroscience Institute (NNI) with Changi General Hospital (CGH) and Khoo Teck Puat Hospital (KTPH) has enabled NNI specialists to assess ischemic stroke patients remotely and provide faster response and optimal treatment round the clock.

The specialists, collaborating with the hospitals’ Accident and Emergency doctors through Tele-stroke’s video conferencing features, were able to make timely assessment of the patients’ suitability for treatment using the clot-busting tissue plasminogen activator (tPA) drug.

If given to eligible patients within three hours of stroke onset, tPA has been shown to improve outcomes and reduce disability. Three months after their stroke episode, the patients who were treated were 30 per cent more likely to have minimal or no disability, noted Dr Rajinder Singh, Consultant at NNI’s Department of Neurology, who was speaking at HIMSS Asia Pacific Conference at Marina Bay Sands on 18 September.

However, before it can be administered, a neurologist has to assess the patient’s suitability and prescribe the medication. With the web-based Tele-Stroke system, the neurologist is now able to remotely examine the patient in real time via video conferencing and evaluate his CT scan and vital signs with the hospital A&E doctor next to the patient.

Since the service was launched in August 2011, Tele-stroke consults have been conducted for over 500 ischemic stroke patients, or 25 to 30 patients a month, and the medication administered to more than 120 patients. This represented a three-fold increase in the number of patients administered with tPA.

Dr Rajinder said Telestroke has given the specialists “virtual mobility” to perform consultations anywhere and revolutionised the way NNI’s limited pool of specialists are being deployed. “We now use a hub-and-spoke model to concentrate neurological  expertise at  NNI to  serve multiple hospitals, to treat more patients more quickly and efficiently,” he said.

“For the patient, Tele-stroke has increased his timely access to specialised neurological expertise closer to home, and increased his chances of recovery from stroke,” he added.

Tele-Stroke was deployed by Integrated Health Information Systems (IHiS), which is currently working with NNI to extend the infrastructure to more hospitals. “Tele-health presents substantial opportunities to improve patient care, in a cost effective and sustainable way,” said IHiS Chief Executive Officer Dr Chong Yoke Sin. “As Singapore’s population ages at one of the world’s fastest rates, and patients with stroke and chronic diseases rise, tele-health will be a vital tool to overcome the shortage of specialised healthcare staff and ensure continued quality patient care.”